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  1.  
  2.  
  3.                             HelpPC Registration Form
  4.  
  5.  
  6.         Name:           ____________________________________________
  7.  
  8.         Address:        ____________________________________________
  9.  
  10.                         ____________________________________________
  11.  
  12.         City/State:     ____________________________________________
  13.  
  14.         Country:        ______________________   Zip: ______________
  15.  
  16.         Telephone:      (________)  _________ - ____________________
  17.  
  18.  
  19.         Diskette preference (circle one):           5.25         3.5
  20.  
  21.                 Number of copies       Price per copy
  22.  
  23.                        1             $25 per diskette
  24.                       2-5            $20 per diskette
  25.                        6+            $15 per diskette
  26.                                      $5 per upgrade (any version)
  27.  
  28.         Number of individual copies   _________   at  $ ________ ea.
  29.  
  30.         Total enclosed                        $ ____________________
  31.  
  32.  
  33.         Where did you first learn about HelpPC?   __________________
  34.  
  35.         Where did you get your copy of HelpPC?    __________________
  36.  
  37.         Do you use CompuServe/Genie/BIX/Prodigy?  __________________
  38.  
  39.         What brand of machine are you using:      __________________
  40.  
  41.         CPU type (circle one):     8088    8086    286    386    486
  42.  
  43.         How fast, how much memory & disk:   ________________________
  44.  
  45.         Video type (circle one):     MDA    CGA    HGC    EGA    VGA
  46.  
  47.         What would you like to see added/changed in HelpPC?  (Please
  48.         attach any additional comments/suggestions to this form.)
  49.  
  50.  
  51.  
  52.  
  53.  
  54.  
  55.  
  56.  
  57.         Mail completed form and check or money order to:
  58.  
  59.                        Dave Jurgens
  60.                        1550 Alton Darby Creek Road
  61.                        Columbus, Ohio 43228
  62.